Why IVF pregnancy is Considered High Risk?
INDICATION FOR IVF/ ICSI
Previous tubal sterilization or removal
Ovulation disorders/ Poor egg quality
Fallopian tube damage or blockage
Unexplained infertility.
Male infertility – Impaired sperm production or function
Endometriosis
Uterine fibroids
IUI failure
Age factor
IVF PREGANACY
A new study suggests – Women who’ve had fertility treatments — especially in vitro fertilization – may be at higher risk for serious pregnancy complications
PRECLAMPSIA
A potentially dangerous pregnancy complication characterised by high blood pressure
Poor placentation, which manifests as pre-eclampsia and fetal growth restriction, is a major pregnancy complication.
Pre-eclampsia usually begins after 20 weeks of pregnancy in a woman whose blood pressure had been normal.
It can lead to serious, even fatal, complications for both mother and baby.
There may be no symptoms. High blood pressure and protein in the urine are key features. There may also be swelling in the legs and water retention, but this can be hard to distinguish from normal pregnancy.
US researchers based at Boston University have found that women who have IVF treatment are more likely to have high blood pressure during pregnancy than women who conceive naturally.
Difference between preeclampsia and gestational hypertension
Preeclampsia is classified as one of four high blood pressure disorders that can occur during pregnancy.
Preeclampsia is diagnosed when a woman with gestational hypertension also has increased protein in her urine.
Gestational hypertension is diagnosed when blood pressure readings are higher than 140/90 mm Hg in a woman who had normal blood pressure prior to 20 weeks and has no proteinuria or other signs of organ damage.
MULTIPLE BIRTH
Multiple births can develop through in vitro fertilization when more than one embryo is put back into the mother’s womb.
Identical twins can develop even when only one embryo is put back into the womb.
Twins, triplets, and other multiple-birth children are at much higher risk of premature or low birth weight than are singleton children. And premature birth and low birth weight are linked to a host of health risks
PREMATURE AND LOW BIRTH WEIGHT
The primary cause for low birth weight is premature birth, being born before 37 weeks gestation; a baby born early has less time in the mother’s uterus to grow and gain weight, and much of a fetus’s weight is gained during the latter part of the mother’s pregnancy.
Women who become pregnant through in vitro fertilization, or IVF, have an 80% higher risk for spontaneous preterm birth before both 37 and 34 weeks gestation
MISCARRIAGE
Miscarriage: 10 – 15 % of all pregnancies end in miscarriage. With in vitro fertilisation (IVF), this risk is approximately 15 – 30 %, which can be attributed to the higher average age of the patients.
One of the most common reasons as to why an IVF cycle fails is due to the quality of the embryo.
Poor sperm quality can be the cause [of miscarriage] in about 6% of couples
In fact, using preimplantation genetic diagnosis (PGD) may reduce your risk of miscarriage in an IVF pregnancy if you already have a history of past miscarriages prior to the treatment
ECTOPIC PREGNANCY
Embryos can migrate. Even if the embryo is implanted in the womb, there is still the chance of an ectopic pregnancy.
The fertilised egg can’t survive outside the uterus. If left to grow, it may damage nearby organs and cause life-threatening loss of blood
The close examination carried out during fertility treatment results in early detection and treatment of ectopic pregnancies.
GESTATIONAL DIABETES
Gestational diabetes is a condition in which your blood sugar levels become high during pregnancy
Babies of mothers who have gestational diabetes have a higher risk of developing obesity and type 2 diabetes later in life.
Untreated gestational diabetes can result in a baby’s death either before or shortly after birth
Researchers found that singleton pregnancies achieved by assisted reproductive technologies were associated with a higher risk for gestational diabetes
PLACENTA PREVIA
It is a condition in which the placenta partially or wholly blocks the opening of cervix, thus interfering with normal delivery of a baby.
This puts the baby at risk for complications related to premature birth, including breathing problems, low birth weight, and birth injuries
Risk of placenta previa was nearly three-fold higher in the pregnancy following assisted fertilization
BIRTH DEFECTS
They found that birth defects were significantly increased for infants born after IVF, compared with naturally conceived infants
The major birth defects seen in babies born via IVF and/or ICSI included heart defects and malformations of the urogenital tract, such as hypospadias (an abnormality in the position of the opening of the urethra in boys)
GROWTH RETARDATIONS
Growth retardation occurs when your fetus doesn’t develop at a normal rate. It’s widely referred to as intrauterine growth restriction (IUGR).
IUGR happens because the fetus doesn’t get enough nutrients and nourishment. This can happen if there is a problem with: the placenta
IUGR can even lead to the baby’s death either in the womb or shortly after birth.Much of this is due to death in the womb, suffocation during birth, and the presence of birth defects.
Several previous studies have shown that intrauterine growth restriction are more common in the IVF population
MANAGEMENT
ULTRASOUND SCAN
NT SCAN,
ANOMALLY SCAN
GROWTH SCAN
GLUCOSE MONITORING
BLOOD AND URINE INVESTIGATIONS
MONITORING VITALS AND WEIGHT GAIN